Smokh field laboratory

FIELD LABORATORY KIT

Missionary Medicine

LAB RESULTS - DIAGNOSIS/MISDIAGNOSIS

Medical tests are considered to be extremely reliable and objective. However, this is a popular misconception. Tests can be just as subjective as a symptom (which is what a patient complains of) or a sign (which is finding noted by the doctor on clinical examination) . In other words, merely conducting more tests does not ensure better medical care.

Keep in mind, laboratory tests are interpreted in the context of other tests and clinical signs and symptoms, as well as personal and family medical histories; one test is rarely, if ever, diagnostic of anything. A meaningful diagnosis is developed through a careful evaluation of all available evidence, weighted with scientific probabilities, and filtered through the professional knowledge, intuition, and clinical experience of the practitioner/diagnostician.

Thus a cooperative, mutually respectful relationship with your healthcare practitioner is of the utmost importance if you wish to be an active partner in your treatment and other healthcare decision- making.

THE AVERAGE, SO-CALLED, MEDICAL CHECK UP, IS IN MOST CASES ONLY A SCREENING FOR OBESITY, DIABETES, HYPERTENSION, HYPERLIPIDEMIA, AND ANEMIA. More...

A RURAL PRIMARY CARE PHYSICIAN CAN IN FACT DO A BETTER JOB WITHOUT THE TECHNOLOGY, USING SIMPLE TESTS, COMMON SENSE AND CARING!

THIS IS A MANUAL AND A REFERENCE WORK. IT IS TO ACCOMPANY ONE OF OUR TRAINING SESSIONS TO LEARN THE USE OF THE EQUIPMENT.

This manual is mainly intended for the rural laboratory. SIGNS and SYMPTOMS related to diseases, as well as their treatment, are to be found in the Grand Master's ENCYCLOPEDIA OF NATURAL MEDICINE, available on CD. There is also more information in the author’s companion book MODERN MONASTIC MEDICINE.

List of Laboratory Tests this Kit can aid in diagnosis:

DISEASE LIST: TESTS WHICH ARE USEFUL FOR DIAGNOSING VARIOUS DISEASES IN RURAL & TROPICAL AREAS

This list is a guide to show when to use the laboratory procedures listed in combination with physical signs and symptoms. It list tests that might be done when you are considering a possible diagnosis, and what a positive result means. Sometimes a positive test confirms the diagnosis and sometimes it leads you to suspect another diagnosis which is the true one. For example, if you think your patient has an acute abdomen but his urine shows glucose, it is possible that his abdominal pains are due to dia betic acidosis. If you think your patient has African sleeping sickness but his sedimentation rate is normal, this eliminates that ,agnosis.
Results & Interpretation: + means Positive result, and - means Negative result. "Confirmative" means that this result could be caused by the disease in question, but it does not imply that the opposite result could never be found. The best tests for a particular disease or symptom are those where a positive result means one thing and a negative result points to anot her, or where there is a clear difference in meaning for different ranges of quantitative measurements.

CONTENTS

1. Rolling Travel Case, aluminum

2. Digital Microscope, 12 volt battery operable, with 3.5 Screen, 40x, 400x and 1600x Magnification (laptop compatible)

3. Full set of reagents, 1 oz. bottles

4. Glucose/cholesterol/uric acid portable meter with reagent sticks.

5. Refractometer

Note: Kit not provided to US domestic practitioners.

Herbs, general

Universal Human Rights

Modern Monastic Medicine

Related Topics

Our first kit was developed on Nevis Island and field tested in Cebu, Philippines, following in the mountains of Nepal.

DISEASE	SPECIMEN	TEST	RESULTS & INTERPRETATION
Acute abdomen	Urine	Glucose	+ consider diabetic acidosis
	Urine	Ketones	+ confirmative, consider diabetic ketoacidosis
	Urine	Urobilinogen	+ consider malaria, thallasemia, sickle cell disease, other liver disease, drug intoxication
	Urine	Nitrite	+ consider urinary tract infection
	Urine	Bilirubin	+ consider hepatitis, leptospirosis, other liver disease
	Stool	Blood	+ consider enteric (typhoid) fever
	Blood smear	Blood smear: Schizonts Trophozoites Gametocytes	Patients can present with acute abdominal pain, guarding and rigidity, mimicking bowel perforation, acute appendicitis, acute cholecystitis, ureteric colic, etc. (Malaria can mimick almost anything!)

African sleeping sickness	Blood	Sedimentation rate	Very high (above 60), confirmative; Intermediate (30-60), doubtful; Normal (below 30), eliminates
Human African Trypanosomias	Blood	Blood smear	A wet smear of unstained blood or Giemsa-stained thick smear (more sensitive) is used to observe the mobile trypanosomes It requires immediate search for parasites because they are mobile for only 15-20 minutes.
	Blood	Hemoglobin	Low, confirmative
	Lymph	Lymph node aspiration	A rapid test for trypanosomes at a high dry magnification (X 400). It requires immediate search for parasites because they are mobile for only 15-20 minutes.
	Cerebrospinal fluid	Lumbar puncture	Lumbar puncture should always be performed in patients with parasitemia or lymphadenopathy. The double centrifugation technique is the most sensitive method to detect the trypanosomes
AIDS	Urine	Ketones	+ confirmative
	Blood	Formol gel	+ confirmative
	Blood	Hemoglobin	Low, confirmative
	Blood	Dry Mount	Significant puddling and dyscrasia in active and late stages
	Saliva	OraQuick dipstick	Orasure Technologies, Medford, N.Y.
	Blood	Whole blood dipstick	+HIV-1, Hema Diagnostic Systems, U.S.
Allergy	Urine	Nitrite	+ consider urinary infection
	Urine	Bilirubin	+ consider liver disease
	Stool	Hematest	+ consider schistosomes, other worms
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
	Skin	Patch or Scratch test	+ if skin reddens as a reaction to the antigen
Ameobic liver disease (abscess)	Urine	Bilirubin ErlichÕs diazo reagent	+ confirmative + confirmative Pink or Red
	Blood	White Cell Count	There is usually a moderate leucocytosis accompanied by an absolute or relative increase in neutrophils.
	Blood	Hemoglobin	Anemia is common in ALA.
	Stool	Microscopic	If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.
Ameobic dysentery	Stool	Microscopic	If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.
	Blood	White Cell Count	+ Leucocytosis, confirmative
Anemia	Blood	Hemoglobin	+Low; Normal, eliminates
	Blood	Microscopic	Differential of microscopic and macroscopic forms
	Stool	Hematest	+ confirmative, helps to find cause
Arterio/Athero-sclerosis	Blood	Cholesterol	+ > 200 mg.%
	Blood	Microscopic Live Blood	+ Cholesterol chards
	Nails	Capillary refill time	+ > 2 seconds
	Skin	Head to toe temperatures	+ If the head temperature is 3¼C > than temp. at the bottom of the feet.
Arthritis	Blood	Sedimentation rate	Normal, implies arthritis due to previous injury or old age; High, implies other kinds of arthritis
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Ascariasis	Urine	Ketones	+ indicates severe case
	Stool	Microscopic	+ characteristic ova
	Blood	White Cell Count	+ Eosinophilia
Asthma	Urine	Nitrite	+ consider urinary infection
	Urine	Bilirubin	+ consider liver disease
	Stool	Hematest	+ consider schistosomes, other worms (until proven otherwise)
	Stool	Clinitest (4)	+ confirmative or milk intolerance
	Blood	White Cell Count	+ Eosinophilia indicates allergy and/or parasitosis
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
Cancer	Blood mount	Lagoons with broken fields	+ confirmative
	Blood	Sedimentation rate	High, severe disease, spreading malignancy Normal or low, early disease or none
	Blood	Hemoglobin	Low, confirmative
	Urine	Carcinochrome reaction	+ Confirms, or raises suspicion levels when albuminuria is present
	Blood	HartmanÕs & Koch Crenation Test	+ When 5 or more RBCÕs fail to crenate in 1% saline, in a microscopic field
	Blood	Blood smear	+ characteristic presence of increased platelets (thrombocytosis)
Cancer, Cervical	Epithelial scraping	Pap test cytology	+ characteristic change in nuclei
	Epithelia	SchillerÕs test	+ if cervix fails to retain tincture of iodine stain
Cancer, Bladder	Urine	Pap test cytology	+ characteristic change in nuclei
Cancer, Bronchopulmonary	Bronchial aspirate (sputum)	Pap test cytology	+ characteristic change in nuclei. Morning collection of sputum in smokerÕs can be preserved in vodka.
Cancer, Gastric	Gastric contents	Glycyltrophan test	+ Reddish color on addition of glucose & bromine
Cancer, Melanoma	Urine	ThormahlenÕs test	+ Deep blue color
	Urine	Ferric chloride	+ Deep black color
Chaga's disease	Urine	Bilirubin	+ confirmative
American Trypanosomiasis	Urine	Urobilinogen	+ confirmative
Chlamydia	Whole Blood	Dipstick	+ confirmative; Hema Diagnostic Systems, U.S.
Cholera	Urine	Urobilinogen	+ consider malaria
	Stool	Clinitest	- for cholera; confirmative for osmotic diarrhea or milk intolerance (a sensitive differential diagnosis)
Chronic Obstruc-tive Pulmonary Disease	Breath	Breath holding <20 sec. Pitting edema Capillary refill > 2 sec. Tachycardia, dyspnea	+ confirmative
	Breath	Match Test	+ Failure to blow out a match held 6 inches out, exhalation through pursed lips
Cirrhosis, hepatic	Urine	Urobilinogen	+ confirmative
	Urine	Bilirubin	+ confirmative; - eliminates

	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Colic (simple)	Stool	Blood	+ consider some other cause
(see also acute abdomen, gall bladder disease, dysentery)			- confirms simple colic
	Stool	Clinitest	+ consider milk intolerance
	Enteric	Epsom salt challenge	+ of diagnostic and therapeutic value in Gallstone colic and severe constipation. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic. The ordinary dose as a mild laxative is a heaping teaspoonful; as a cathartic, two to four teaspoonfuls. The taste may be improved, if necessary, by the addition of a little lemon juice and sugar.
Dehydration	Urine	Specific gravity	High, confirmative Normal or low, eliminates
	Urine	Color	+ Dark yellow (moderate) to deep orange/brown (severe)
	Skin	Skin Tenting	High, confirmative

Dengue fever	Urine	Ketones	+ consistent
	Urine	Blood	+ may be hemorrhagic fever
	Stool	Blood	+ may be hemorrhagic fever
Depression	Blood	Sedimentation rate	Normal, confirmative; High, indicates a physical cause
	Blood Pressure	Elevated right sided systole & diastole
Diabetes	Urine	Glucose	+ confirmative
			- mild, well-treated, or over-treated
	Urine	Ketones	+ confirmative, severe, under-treated
	Blood	Glucose	+ High, confirmative, needs treatment; Low, over-treated or eliminates; Normal, well-treated or eliminates
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
Diarrhea	Stool	BenedictÕs test	+ Yellow orange to greenish (some sugar) is specific for osmotic diarrhea vs. enteropathic
Dysentery	Stool	Hematest	+ confirmative; - consider ordinary diarrhea
	Urine	Nitrite	+ confirmative
Enteric (typhoid) fever	Stool	Hematest	+ confirmative, severe case
	Urine	ErhlichÕs diazo	+ Pink or red
	Urine	GerhardtÕs acetoacetic acid test	+ deep red
	Urine	Nitrite	+ confirmative
	Urine	Russo typhoid reaction	+ Early stages urine change light green to addition of 4 drops methylene blue, emerald green at the height, blue during the decline
	Blood	White Blood Cell Count	+ Leucopenia
Filariasis	Urine	Protein	+ confirmative
	Blood	BrugiaRapid	+ specific IgG4 antibodies against Brugia filarial parasites; BioDiagnostic Research SDN BHD, Malaysia
Gallbladder disease; gallstones	Urine	Bilirubin	+ confirmative
	Enteric	Epsom salt challenge	+ of diagnostic and therapeutic value in Gallstone colic. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic.
Gastroenteritis	Urine	Ketones	+ confirmative; - mild disease
	Urine	Glucose	+ consider diabetes
	Stool	Clinitest	+ consider milk intolerance
Giardiasis	Urine	Ketones	negative ; if + confirmative
	Stool	Clinitest	+ consider milk intolerance
Gonorrhea	Urine/pus	Microscopy	+ confirmative with gram negative diplococci (in pairs)
	Whole Blood	Dipstick	+ confirmative; Hema Diagnostic Systems, U.S.
Heart failure	Urine	Protein	+ confirmative
		Breath holding <20 sec. Pitting edema Capillary refill > 2 sec. Tachycardia, dyspnea	+ confirmative
	Blood	Leucocytosis	+ confirmative, severe
Heat stroke	Urine	Blood	+ confirmative, severe
	Urine	Protein	+ confirmative, severe
Hemorrhagic fever, viral	Urine	Blood	+ confirmative
	Stool	Hematest	+ confirmative
	Blood	Hemoglobin	Low, confirmative
Hepatitis	Urine	Bilirubin	+ confirmative; - eliminates, or early stage
	Urine	Urobilinogen	+ confirmative, see malaria also
	Urine	Ketones	+ confirmative
	Blood	Dipstick	+ confirmative B & C; – eliminates (KIT Biomedical Research, the Netherlands)
Hookworm	Stool	Hematest	+ confirmative; - improbable if neg. three times
	Stool	Ova & Parasite	+ However, because egg laying may be delayed, stool examination should not be considered a sensitive test for identifying hookworm infection. Stool examinations may need to be repeated.
	Blood	Microscopy	+ Macrocytic (iron deficiency) anemia
	Blood	Hemoglobin	Low, confirmative
	Blood	White Cell Count	+ differential reveals eosinophilia (1000-4000 cells/mcL)
Hypoglycemia	Blood	Glucose	Normal or high, eliminates; Low, confirms

Intestinal fluke	Urine	Ketones	+ confirmative
	Stool	Clinitest	if + consider milk intolerance
Irritable bowel	Stool	Hematest	if + consider another cause
	Stool	Clinitest	if + consider milk intolerance
Jaundice	Urine	Bilirubin	+ confirmative; - eliminates, or early stage
	Urine	Urobilinogen	+ confirmative, - seen in obstructive jaundice
	Blood	HamelÕs test	+ serum yellow
Kidney failure	Urine	Protein	+ confirmative, esp. nephrotic
	Urine	Blood	+ confirmative
	Urine	Specific gravity	VolhardÕs (AlbarranÕs) dilution test
	Blood	Hemoglobin	Low, confirmative; Normal, recent onset or eliminates
	Breath odor	Fetid, fishy, metallic	+ indicates accumulation of ammonia and urea

Kidney infection	Urine	Nitrite	+ confirmative; - early or eliminates
	Urine	Blood	+ confirmative; - early or eliminates
	Urine	Protein	+ confirmative
	Urine	pH	pH 8 or higher, confirmative
	Urine	GerhardtÕs acetoacetic acid	+ Deep red color
Kidney stone	Urine	Blood	+ confirmative; - not always eliminates
	Urine	Microscopy, SternheimerÕs stain	pH <6.5: oxalate crystals/stones pH >7.0: staghorn calculi
	Back	Kidney Punch	+ Costovertebral tenderness
Lassa fever	Urine	Blood	+ confirmative
	Stool	Blood	+ confirmative
	Blood	Hemoglobin	Low, confirmative
Lead poisoning	Blood	Hemoglobin	Low, confirmative
			Normal, mild, recent, or eliminates
Leprosy	Blood	Dipstick	+ confirmative; – eliminates (KIT Biomedical Research, the Netherlands)
	Blood	Formol gel test	+ confirmative; - eliminates, or very early disease
Leptospirosis	Urine	Urobilinogen	+ confirmative
	Urine	Bilirubin	+ confirmative
	Urine	Protein	+ confirmative
Liver failure	Urine	Bilirubin	+ confirmative; - eliminates
	Urine	EhrlichÕs diazo	+ pink or red
	Urine	Urobilinogen	+ confirmative
Liver fluke	Urine	Bilirubin	+ confirmative
Lyme disease	Blood	Live Blood microscopy	+ Spirochetes will crawl out of the RBCÕs sitting 4 hrs. at room temperature
Malabsorption	Urine	Ketones	+ confirmative - mild case or eliminates
	Blood	Hemoglobin	Low, confirmative
	Stool	Clinitest	+ due to milk intolerance
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
Malaria		Urobilinogen	+ confirmative; - questionable²
	Whole Blood	Dipstick	+ confirmative; Hema Diagnostic Systems, U.S.
	Blood	Hemoglobin	Low, confirmative
Malnutrition	Urine	Ketones	+ confirmative; - indicates recent food intake
	Urine	Color	+ Pale, indicates low protein dietary
	Blood	Hemoglobin	Low, confirmative
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
Measles	Urine	ErhlicÕs Diazo reaction	+ confirmative
Meningitis	Urine	Ntrite	+ confirmative
Milk intolerance		Clinitest	+ confirms the diagnosis; - eliminates the diagnosis
Mushroom poisoning	Urine	Bilirubin	+ confirmative
	Urine	Urobilinogen	+ confirmative
	Skin snip	Microscopic biopsy	+ examined 15 minutes to 3 hours later to see whether or not microfilariae have emerged
Ovalocytosis	Urine	Urobilinogen	+ confirmative; - questionable ³
	Blood	Microscopy	+ RBCÕs oval-shaped instead of round. It is a form of hereditary elliptocytosis.
	Blood	Hemoglobin	Low, confirmative
Parasites	Stool	EGGS PLUS	+ Eggs > 100 per microscopic field
Pellagra	Urine	pH	+pH of 8+; pH 7 or less, questionable
	Blood	Hemoglobin	Low, confirmative
	Urine	Ketones	+ confirmative
Pelvic Inflammatory Disease	Blood	Leucocytosis	+ confirmative, severe
See Chlamydia	Vaginal smear	GramÕs stain	- negative intercellular diplococci
	Blood	Sedimentation rate	+ Increased
Peptic ulcer	Stool	Hematest	+ confirmative
	Blood	Hemoglobin	Low, confirmative
Phenylketonuria	Urine	Ferric chloride	+ Deep green color
Pigbel (necrotizing enteritis)	Stool	Hematest	+ confirmative
	Blood	White Blood Cell Count	+ Leucocytosis (unlike leucopenia of typhoid)

Pneumonia	Urine	Bilirubin	+ confirmative
	Urine	Urobilinogen ErlilchÕs diazo	+ confirmative Egg yellow reaction
	Urine	GerhardtÕs acetoacetic acid	+ Deep red color
	Urine	FantusÕ test	+ Urinary chlorides decreased
	Blood	Leucocytosis	+ confirmative, severe
Puerperal fever Childbed fever	Urine	ErlichÕs diazo	+ confirmative
Relapsing fever	Urine	Bilirubin
	Urine	Protein	+ confirmative, not much
	Urine	Urobilinogen	+ confirmative
	Urine	Blood	+ confirmative with severe disease
	Stool	Hematest	+ confirmative with severe disease
Rheumatic fever	Blood	Sedimentation rate	+ High, confirmative
Rheumatoid Arthritis	Blood	Leucocytosis	+ confirmative, severe
	Synovial fluid aspirate	Mucin clot test (RopeÕs test)	+ confirmataive, a few drops of 5% acetic acid to 1 ml
	Synovial fluid	Mucin Clot Test	+ confirmative, severe
Scarlet Fever	Urine	GerhardtÕs acetoacetic acid	+ Deep red color
Schistosomiasis hematobium	Urine	Blood	- eliminates if repeatedly neg.
	Urine	Hatch Test	+ eggs hatch from miracidia
	Urine	Microscopy	+ direct examination reveals the eggs
Schistosomiasis japonicum	Stool	Hematest	+ confirmative; - questionable if repeatedly neg.
	Urine	Microscopy	+ direct examination reveals the eggs
	Urine	Bilirubin	+ confirmative
Schistosomiasis mansoni	Stool	Hematest	+ confirmative; - questionable if repeatedly neg.
	Stool	Hatch Test	+ eggs hatch from miracidia
	Urine	Bilirubin	+ confirmative
	Urine	Microscopy	+ direct examination reveals the eggs
Sickle Cell Anemia	Blood	Sickling Test	+ confirmative, severe (sickling induced by sodium metabisulfate or ascorbic acid solution)
Scurvy	Stool	Hematest	+ confirmative (swallowed blood); - questionable if repeatedly neg.
	Urine	Silver Nitrate Test	+ Negative confirmative
	Blood	Hemoglobin	Low, confirmative
	Blood	Dry Blood Mount	Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
Sepsis / Trauma	Urine	Urobilinogen	+ confirmative
	Urine	Bilirubin	+ confirmative
	Urine	Protein	+ confirmative
	Blood	Leucocytosis	+ confirmative, severe

Sickle cell disease	Urine	Urobilinogen	+ confirmative; questionable if repeatedly negative
	Urine	Bilirubin	+ confirmative
	Blood	Hemoglobin	Low, confirmative
	Blood	Microscopy	+ Sickling test postive
Spotted fever	Urine	Bilirubin	+ confirmative
	Blood	White Blood Cell Count	+ Leucocytosis
Sprue	Stool	pH	pH 6 or less, confirmative
			pH 7 or more, eliminates
	Blood	Hemoglobin	Low, confirmative
Strongyloidiasis	Stool	Hematest	+ confirmative
	Stool	Microscopic, Ova & Parasite	+ confirmative
Thallasemia	Urine	Urobilinogen	+ confirmative
			- eliminates, or no current crisis
	Blood	Hemoglobin	Low, confirmative; Normal or high, eliminates or mild

Syphilis	Whole Blood	Dipstick	+ confirmative; Hema Diagnostic Systems, U.S.
Toxemia of Pregnancy (Eclampsia)	Urine	Protein	+ confirmative; - nearly eliminates
	Blood	High Blood Pressure	+ confirmative (esp. with nausea, vomiting, headaches); - nearly eliminates


TravelerÕs diarrhea	Urine	Ketones	+ confirmative, severe, or vomiting also
	Stool	Clinitest	+ consider milk intolerance
	Stool	Hematest	+ consider dysentery
Tropical splenomegaly	Urine	Urobilinogen	+ confirmative; - eliminates if repeatedly neg.
	Blood	Hemoglobin	Low, confirmative
Tuberculosis	Skin	Tuberculin (Mantoux) Test	+ confirmative, the Gold Standard
	Whole Blood	Dipstick	+ confirmative; Hema Diagnostic Systems, U.S.
	Urine	ErhlichÕs diazo	+Pink or red
	Urine	Urochromogen of Weiss	+ caranry yellow upon addition of 0.1% potassium permanganate
Typhus	Urine	Bilirubin	+ confirmative with severe disease
	Urine	Urobilinogen	+ confirmative with severe disease
Urinary infection	Urine	Nitrite	+ confirmative with severe disease; - eliminates E. coli
	Urine	Leucocytes	+ confirmative
	Urine	pH	+ pH 8 or more, confirmative for urease producing germs (urine will rise in pH upon standing)
	Urine	Blood	+ confirmative
	Urine	Protein	+ confirmative
Visceral leishmaniasis	Urine	Urobilinogen	+ confirmative; - eliminates if repeatedly neg.
	Blood	Hemoglobin	Low, confirmative
	Blood	Formol gel test	+ confirmative; - eliminates, or very early disease
West Nile Virus	Blood	Dipstick	+ confirmative; – eliminates (KIT Biomedical Research, the Netherlands)
Yellow fever		Bilirubin	+ confirmative; - eliminates, or early disease
	Urine	Urobilinogen	+ confirmative
	Urine	Blood	+ confirmative
	Stool	Blood	+ confirmative

1. bilirubin should be greater than the urobilinogen for hepatitis. If the urobilinogen is greater, the patient primarily has a blood disease such as malaria.

2. Malaria is a questionable diagnosis if the urine produced during the time of shaking chills (i.e. collected an hour or two after the onset of the chills) is confirmatively negative for urobilinogen with repeated determinations.

3. The diagnosis is questionable if the urine is confirmatively negative for urobilinogen all the time. However, it may be negative when the person feels fine and turn positive during an illness.

4. Clinitest: The Clinitest reaction detects all reducing substances (substances that will reduce the copper salts present in the tablet in a hot solution). Reducing substances that will cause a reduction of the copper salts are glucose, lactose, fructose, galactose, and pentose. The Clinitest has also been used to detect reducing substances in stools of children with diarrhea. For diarrhea in children the differential diagnosis includes primary and secondary disaccharidase deficiencies in addition to monosaccharide malabsorbtion. The Clinitest on stools can also distinguish between diarrhea caused by abnormal excretion of various sugars and those caused by various viruses and parasites. In a healthy term infant the presence of reducing substances in the stool is not uncommon and usually not associated with carbohydrate intolerance. For premature infants, however, there is a strong association between a positive Clinitest and necrotizing entercolitis.

DISCLAIMER: The Medical Order of the Knights of Hope (SMOKH) publications and web site is intended to provide general educational information and to help users understand more easily for health care services. This Manual is not an attempt to practice medicine or provide specific medical advice, and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Nor should users rely upon this book or the SMOKH web site if they might need emergency medical treatment. We strongly encourage users to consult with a qualified health care professional for answers to personal questions or problems. Use of this book or information on the SMOKH web site does not establish a doctor-patient relationship.

You assume full responsibility for using any of the information in this Manual, and you understand and agree that SMOKH and its affiliates, are not responsible or liable for any claim, loss, or damage resulting from its use by you or any user. While we try to keep the information as accurate as possible, we disclaim any warranty concerning its accuracy, timeliness, and completeness, and any other warranty, express or implied, including warranties of merchantability or fitness for a particular purpose.